Ludwig’s angina

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Oropharynx

Submandibular space infection; Sublingual space infection

If the swelling blocks the airway, this is an emergency situation!

The goal of emergency treatment is to maintain an open airway. This may involve intubation (breathing tube placed through the mouth or nose and into the lungs) or tracheostomy (direct opening to the lungs through surgical placement of a tube at the base of the neck).

The next major goal is to cure the infection. Antibiotics, usually penicillin or penicillin-like drug, are often given intravenously (in a vein) until the symptoms diminish. Then, the antibiotics are continued as oral medications until the person no longer tests positive for the bacteria.

Dental treatment may be needed to treat tooth infections that cause Ludwig's angina.

Surgery may be recommended, including drainage of the swelling through cuts (incisions) or placement of drains (tubes) in the neck.

Ludwig's angina can be life threatening, but can be cured with proper protection of the breathing passages and adequate antibiotic therapy.

• airway blockage (life-threatening -- see CPR if necessary)
• generalized infection (sepsis)
• septic shock

Call your health care provider if symptoms indicate Ludwig's angina may be present, or if Ludwig's angina has been diagnosed and symptoms do not improve after treatment.

Go to the emergency room or call the local emergency number (such as 911) if difficulty breathing occurs.

Review Date: 06/15/2005
Reviewed By: Monica Gandhi, MD, MPH, Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.